Discharge from the NICU
As NICU babies get stronger, they may no longer need intensive medical and nursing care. At this stage, your baby may either be transferred to a community level 2 nursery closer to your home or discharged directly to your care at home.
Going home
Your baby’s care team will ensure that your baby is ready for discharge (to your home) before your bring them home. The team will also talk with you to make sure that:
- You understand the medical treatments your baby has received
- You understand your baby’s medical and developmental follow-up needs
- You are comfortable caring for your baby at home, including feeding, bathing and giving medication
- You have attended the NICU safety class
- Your baby has had a hearing test or you know how to arrange for one
- You are comfortable using a car seat
- Your baby has a primary care physician and an appointment booked two or three days after discharge
- You know about any other appointments you need to bring your baby to
- You know where to go if your baby is unwell after going home
If your baby is ready to go home directly from Mount Sinai Hospital, we will set a target discharge date, and you should be prepared to take your baby home within 24 hours of that date.
When your baby is discharged from the NICU, you will get a copy of the discharge summary for your records.
If your maternity leave was deferred, remember to inform your employer of your baby's discharge.
Transferring to a level 2 NICU
When your baby is more stable and no longer needs the intensive care provided at Mount Sinai, they may be transferred to a level 2 nursery closer to your home. This is a sign that your baby is progressing well, and it will bring your baby one step closer to discharge home.
Our team tries to give you a choice of hospital by asking you to choose two hospitals in your community.
Although we try to give you as much warning as possible, the transfer to a level 2 community hospital can happen very quickly.
The transition makes it easier for you to visit and care for your baby. You will also get to know the hospital, staff and services that you may need to use in the future.
The transfer process involves the following steps:
- We will check on the bed availability at your chosen hospital each morning. When a bed becomes available, we will call you before your baby is transferred. It is important that we have your up-to-date contact information.
- Once a space is found, we will arrange for your baby to be transferred by ambulance with a nurse.
- We will send a discharge summary (written report) outlining the medical care provided at Mount Sinai. We also transfer your information directly to the other hospital. A report is exchanged from nurse to nurse and another from physician to physician.
The level 2 nursery will focus on preparing your baby to be strong enough to go home.
Feel free to contact the new nursery directly if you wish to take a tour or find out more information, before your baby is transferred.
Preparing to go home
As you get ready to bring your baby home, you may feel a mix of excitement and anxiety. It is normal to feel unsure about providing care for your baby and managing any health issues. Our NICU team will support you during this transition by helping you feel comfortable caring for your baby.
During your NICU stay, you will accomplish the following:
- Active involvement in your baby’s care as part of our integrated model of care
- Bathing, diaper changing and dressing your baby
- Feeding your baby
- Giving oral medication
- Providing comfort and settling your baby
- Understanding your baby's cues for hunger, over-stimulated or tiredness
- Recognizing signs and symptoms of illness
- Feeling comfortable positioning and handling your baby
- Learning about any specific care your baby may need at home
Choosing a physician for your baby
Choosing a physician for your baby before discharge is important.
Your family physician may be comfortable taking care of your baby and consulting with a paediatrician when necessary. If a paediatrician is suggested, ask for a recommendation from your family physician or from a friend.
The NICU team can also help if you are having difficulty finding a physician in your community.
Provide the chosen physician’s name to your baby's NICU nurse or physician as soon as possible.
Buying a car seat
Make sure your baby is always in an appropriate car seat when travelling in a vehicle. Please see the links below and speak with your baby’s nurse to learn more about which car seat to buy.
Your baby at home
The first weeks at home are an adjustment period for both parents and baby. Remember the following advice to help with the transition:
- Take time to enjoy your baby
- Get to know your baby’s awake, sleep, hunger and play cycles
- Get to know your baby’s cues for interaction or needs for quiet time
- Try to step out of the house for a while
- Trust your instincts. Remember that you, as parents, are doing a great job.
Remember that parent support is available. Reach out to your family physician and local community agencies to find parenting and mental health support. Please keep the lines of communications open.
Preterm personality
Your preterm baby is less mature than a full-term infant and may require more time to adjust to the rhythms and routines of daily life. Your preterm baby may be different from full-term babies in the following ways:
- Fussier and more challenging to soothe
- Harder to learn when they are hungry, sleepy or overstimulated
- Take longer to feed, tiring more easily and falling asleep during the feed
Consider keeping a chart of feeding, sleeping and fussy times as well as frequency of bowel movements. This will help you identify patterns and provide a clearer picture of what to expect.
Quarterly newsletter
Stay connected after your discharge from the NICU by reading our informative quarterly newsletter.